Individual provider Active NPI

Emily Brooks, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1316135007
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60478563 Issued in WA
Practice address
501 SE 172ND Ave
#130
Vancouver, WA 98684-9542
Phone
(360) 882-2778
Fax
(360) 604-1772
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10275 OR
Physician Assistant 363A00000X PA60478563 WA Primary

Addresses

Primary practice location

501 SE 172ND Ave
#130
Vancouver, WA 98684-9542

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

Other names 1

  • Emily Fitz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141022001551 WA Practitioner - Physician Assistant 1254429525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

501 SE 172ND Ave
Vancouver, WA 98684-9542
Phone (360) 882-2778

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10275ORMDPhysician Assistant
PA60478563WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Nov 3, 2014 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Nov 3, 2014 Accepting new patients
The Vancouver Clinic Inc PS Past Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

501 SE 172nd Ave
#130
Vancouver, WA 98684

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

501 SE 172nd Ave
Ste 130150
Vancouver, WA 98684

Interoperability endpoints

  • Direct secure messaging: ebrooks8936@tvc-direct.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1316135007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE",
            "address_2": "#130",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986849542",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA10275",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60478563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "FITZ",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.